WHAT IS AUTISM?
so what is autism?
Autism is a neurodevelopmental condition that affects the way an individual experiences the world around them. For me, being autistic means intense autistic joy from indulging in my special interests and honing my skills, but also lifelong loneliness and being misunderstood.
The world’s understanding of Autism is constantly evolving, with the first ‘coining’ of autism only being just over 100 years ago. Autism is a spectrum, and it is often referred to by people as ‘Autism Spectrum Disorder’ (ASD), although this is the official diagnostic term, many people including myself prefer to use the term Autism Spectrum Condition (ASC), as this more accurately represents our experiences as we are not ‘disordered’.
the autism spectrum isn’t linear
When people hear 'Autism Spectrum, ’ they often think of a linear scale from ‘less autistic’ to ‘more autistic,’ but this isn’t the case. No one is ‘more’ or ‘less’ Autistic than any other autistic person, and the autism spectrum looks more like the image displayed. With multiple categories that autistic people experience challenges in, creating a ‘spiky’ profile of skills.
What are the main symptoms of autism?
Autistic people often refer to their experiences directly related to their autism as ‘Autistic traits’ or ‘Autistic characteristics’. These can vary greatly from one person to another, depending on a multitude of factors such as co-occurring conditions, support needs, and access to support.
Below, I will talk through the official diagnostic criteria as laid out by the DSM-5; in this section, I will use the official language as used in the criteria, which does not necessarily reflect the language I use personally.
autism Diagnostic Criteria
The DSM-5 breaks down the diagnostic criteria for Autism into five ‘buckets’ labelled A - E which all have to be met in varying ways in order for a diagnosis of Autism to be made. Buckets A and B are the most crucial ones during the assessment of autism and the traits experienced, whereas buckets C - E are used subsequently to ensure that differential diagnoses are considered and ruled out.
(To read more about the diagnostic criteria or for more detailed support and examples: https://www.cdc.gov/ncbddd/autism/hcp-dsm.html )
Bucket A
Within bucket A, there are three sub-buckets (or sub-categories), and an individual must meet all three of the sub-buckets to meet criteria A.
Bucket A reads: “Persistent deficits in social communication and social interaction across multiple contexts, as manifested by the following, currently or by history (examples are illustrative, not exhaustive):
Deficits in social-emotional reciprocity range, for example, from abnormal social approach and failure of normal back-and-forth conversation to reduced sharing of interests, emotions, or affect to failure to initiate or respond to social interactions.
Deficits in nonverbal communicative behaviours used for social interaction, ranging, for example, from poorly integrated verbal and nonverbal communication; to abnormalities in eye contact and body language or deficits in understanding and use of gestures, to a total lack of facial expressions and nonverbal communication.
Deficits in developing, maintaining, and understanding relationships, ranging, for example, from difficulties adjusting behaviour to suit various social contexts to difficulties in sharing imaginative play or in making friends to the absence of interest in peers.
It is important to note that the diagnostic criteria were primarily created and documented through observing white cis-boys, and we know from more recent research of autistic people who are racialised women, or genderqueer that autism can present differently for them.
Although the diagnostic criteria currently remain unchanged, and individuals must meet the criteria in order to be autistic, it is important not to take it too literally and to think about how situations such as masking may alter the presentation of these traits.
Bucket B
Within bucket B, there are four sub-buckets (or sub-categories); unlike bucket A, only 50% (two) of these must be present for an individual to meet the diagnostic criteria.
Bucket B reads: “Restricted, repetitive patterns of behaviour, interests, or activities, as manifested by at least two of the following, currently or by history (examples are illustrative, not exhaustive):”
Stereotyped or repetitive motor movements, use of objects, or speech (e.g., simple motor stereotypes, lining up toys or flipping objects, echolalia, idiosyncratic phrases).
Insistence on sameness, inflexible adherence to routines, or ritualized patterns of verbal or nonverbal behaviour (e.g., extreme distress at small changes, difficulties with transitions, rigid thinking patterns, greeting rituals, need to take the same route or eating the same food every day).
Highly restricted, fixated interests that are abnormal in intensity or focus (e.g., strong attachment to or preoccupation with unusual objects, excessively circumscribed or perseverative interests).
Hyper- or hyporeactivity to sensory input or unusual interest in sensory aspects of the environment (e.g. apparent indifference to pain/temperature, adverse response to specific sounds or textures, excessive smelling or touching of objects, visual fascination with lights or movement).
buckets C, D & e
These buckets are mainly used to ensure that any potential differential diagnoses are considered and ruled out, these buckets are:
C) Symptoms must be present in the early developmental period (but may not become fully manifest until social demands exceed limited capacities, or may be masked by learned strategies in later life).
D) Symptoms cause clinically significant impairment in social, occupational, or other important areas of current functioning.
E) These disturbances are not better explained by intellectual disability (intellectual developmental disorder) or global developmental delay. Intellectual disability and autism spectrum disorder frequently co-occur; to make comorbid diagnoses of autism spectrum disorder and intellectual disability, social communication should be below that expected for general developmental level.
Are you born with autism?
Yes, every autistic person is born with autism. If somebody displays autistic traits, but this is something that was not present throughout their entire life (ruling out masking) then they do not meet diagnostic criteria for autism.
Autism is not an illness or something that one can acquire, it is a neurodevelopmental condition.
Why do so many people have autism these days?
Although for many, it feels like ‘everyone has autism these days’, this is simply not the case. While we are seeing an increased number of people being diagnosed, we are not seeing an increase in the prevalence of autism.
Autism was only first noted as existing in some form in the early 1900s and was not known as ‘autism’ until it was added to the DSM-III-R in 1987. Prior to this, it had been known as ‘childhood schizophrenia’.
Due to how recently autism has become a diagnosis, and the historical tendency for it to have been observed by clinicians in white cis-boys, we are still developing our understanding of autism, and thus individuals who have spent lifetimes without knowing they are autistic are now being diagnosed. Just as autistic people existed before 1987, the rate of autistic people has been the same, but we are simply getting better at identifying and diagnosing autism.
Can you develop Autism?
No you can’t develop autism, it is a neurodevelopmental condition that is present from birth.
Do vaccines cause Autism?
No, vaccines do not cause autism. This false belief is one that has done a large amount of damage to the autistic community and one that is still perpetuated by some people today.
This has been something that has been a misconception for two main reasons:
A harmful and misleading research article published in 1998 by Andrew Wakefield. This study was subsequently subtracted and found to have been based on scientific misconduct. It was deemed fraudulent, and the data was misrepresented.
People confusing causation and correlation. Most children receive their childhood vaccines around the same age as when autistic traits typically begin to be noticeable by parents. Therefore, many people took this as ‘proof’ that vaccines caused autism.
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